Can I have a vaginal birth after a cesarean section?

If you're pregnant again and your last baby was born by cesarean section, you might be wondering if vaginal delivery might be an option for you this time around. Vaginal delivery after a cesarean section is possible for many women, but there are factors that will help you and your doctor decide if it's right for you.

Safety for you and your child is the most important thing to keep in mind. Vaginal delivery after cesarean section is not always safe for all women.

If you're trying to give birth naturally and you're at high risk for complications, this can create serious problems for you and your baby. That's why it's important that you talk to your doctor about the risks.

How is your health?

In order for you and your doctor to consider having a vaginal birth, you and your baby must be healthy. You can even try vaginal delivery after a C-section if you're pregnant with twins, as long as your doctor says you're all relatively healthy.

Your doctor may suggest that vaginal delivery after a cesarean section is too risky for you to have a successful vaginal delivery. Risks may include any of the following:

Obesity (your body mass index is 30 or higher)
Preeclampsia (high blood pressure during pregnancy)
Age (usually older than 35)
Your previous cesarean was in the last 19 months
The fetus is very large

Previous cesarean section scar

One important detail that you should discuss with your doctor is the type of cesarean scar on the uterus. During a cesarean section, doctors make incisions in two different directions:

Vertical cut goes from top to bottom
Cross section goes from side to side

If your cesarean scar is vertical, you cannot attempt a vaginal birth after a cesarean section. There is a very high risk that your scar will rupture when you try to give birth vaginally, which can cause serious harm to you and your baby. You will need to have another cesarean section.

If your C-section scar is low and transverse, your doctor may allow you to try vaginal delivery after a C-section if your other risk factors are low.

Hospital affairs

Check with your doctor in advance to find out if the hospital you are visiting allows women to attempt vaginal delivery after a cesarean section. Not all hospitals do this.

While there is little risk of an old scar rupturing in a vaginal delivery after a cesarean section, the hospital must be prepared for the emergency that may arise in this case. Some hospitals are simply not ready for this.

Low risk and no risk

Every woman who attempts vaginal delivery after a cesarean section is very unlikely to have her uterus rupture, even if she has a low transverse cesarean scar and is healthy. Doctors cannot be 100% sure if this can happen to you or not.

Even though ruptures occur in less than 1% of vaginal births after an attempted cesarean section, some women don't want to have it at all because if it does, it can be very dangerous. You should weigh all your options and talk to your doctor before deciding what to do.

Benefits of vaginal delivery after cesarean section

If vaginal delivery after a cesarean section is an option for you and you like the idea of trying vaginal delivery, there are several reasons why you might want to do so. Chances are you will succeed: about 70% of women who try can have a baby vaginally. Otherwise, a cesarean section is necessary due to problems that arose during the attempt.

There are many reasons why you might want to try vaginal delivery after a cesarean section because, if successful, they have the following benefits: